We can win, if we choose to fight this

Three of the world's greatest disease threats are on the ropes. Now is the time to throw the knockout punch.

The number of tuberculosis deaths has fallen 41 percent worldwide since 1990. Deaths from malaria are down 33 percent. AIDS-related deaths in low- to middle-income nations have been decreasing steadily since 2005.

"Three critical factors have brought us to this point: the massive scale-up of ? services in the last decade; recent breakthroughs in the science of fighting these diseases; and advances in our understanding of the epidemics through better data," according to a news release from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Some of the advances are both simple and cheap. The percentage of African homes with bed nets to fend off malaria-carrying insects has risen from 3 to 53 since 2000. Some have become cheaper. The cost of drugs to treat HIV/AIDS has fallen from $10,000 to less than $200 a year.

And then there is the concurrent treatment of patients for HIV and tuberculosis. The two diseases frequently strike the same people, and most deaths among HIV-positive people are because of tuberculosis.

The concurrent treatment program has saved an estimated 1.3 million lives from 2005 through 2011. According to the World Health Organization, the concurrent treatment is responsible for the decline in Third World AIDS deaths.

One important scientific breakthrough occurred right here in North Carolina. Researchers at UNC Chapel Hill established that treating HIV-positive people with antiretroviral therapy can massively reduce the risk that they transmit the virus to their uninfected partners.

Improved data has allowed better targeting of areas in need. "In Kenya, the risk of HIV infection can vary by a factor of 10 in adjacent counties." Global Fund says. "One analysis suggests that allocating current resources to the communities most at risk would increase our impact on the AIDS epidemic by 20 percent."

Ken Patterson, of Asheville, Global Grassroots Manager of RESULTS Educational Fund, says: "We saw what happened in the '80s when we let AIDS spiral out of control - it devastated the U.S. and has taken 35 million lives around the globe. Many things that we think won't affect us because they are 'over there' in other parts of the world eventually haunt us if we neglect them. Take drug-resistant tuberculosis - the number of cases has grown dramatically around the globe because of a lack of proper diagnosis and treatment. A disease that can be treated very easily has now evolved, in its worst form, into an untreatable killer. When all it takes is a plane ride to be exposed to it and bring it back home, we are definitely at risk. We should beat these diseases now, when it is within our reach.

"I was in Zambia a week ago on behalf of RESULTS working with leaders of HIV-positive women's and other community groups. It was clear that the investments that the U.S. and other donor nations have made has spared millions of mothers, fathers, children, grandparents, leaders, communities, and nations from devastation."

There are, however, dark linings on these silver clouds. "International funding for malaria control has leveled off, and is projected to remain substantially below the $5.1 billion required to achieve universal coverage," WHO says.

As for tuberculosis, WHO says that, "Between 2013 and 2015, up to $8 billion per year is needed in low- and middle-income countries, with a funding gap of up to $3 billion."

For HIV, "Estimates from 2011 indicated that an effective global response would cost $22 billion to $24 billion annually in 2015," WHO says.

In December, the U.S. will host a donor pledging conference that the Global Fund hopes will raise $15 billion over three years. The key to success is a $5 billion pledge from the U.S., because other donors historically have matched the U.S. contribution 2-for-1.

As the U.S. already puts up $1.65 billion a year, only a slight increase is necessary to reach the three-year figure.

"The confluence of rapid progress, breakthrough science, and better data has opened a window of opportunity to strike a decisive blow against these epidemics," the Global Fund says. "But health experts warn that this window will not stay open if world leaders delay taking action.

"The impressive gains of the last decade are fragile. When TB is not properly treated it becomes more dangerous. ... Malaria nets need to be replaced regularly."

Deaths in the Third World may seem like no big deal for the U.S., but in today's global village, infection is just a plane ride away from anywhere.

Dr. Mark Dybul, executive director of the Global Fund, put the issue succinctly when he said, "We have a choice: We can invest now, or pay forever."

That's about the size of it.

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We can win, if we choose to fight this

Three of the world's greatest disease threats are on the ropes. Now is the time to throw the knockout punch.